Pneumonia Flashcards
1
Q
Which A-E
A
B
2
Q
Airway
A
3
Q
Breathing
A
Look: increased WOB, use of accessory muscles
Listen: crackles, bronchial breathing
Feel: dulness on percussion, chest expansion, tracheal deviation
- O2 - Low
- RR - High
- XCR stat
- ABG - Type I respiratory failure, lactate >2
- Sputum culture
- Do a quick CURB 65 score (3 or more consider ITU)
* Confusion
* Urea > 7
* RR > 30
* BP < 90
* 65 years old
.6. Do a qSOFA score
* RR > 22, SBP <90, GCS
Initial management:
- sit up
- O2 15 L via NRBM
- start antibiotics (SEE ALLERGIES FIRST)
if CAP:
- Amoxicillin 500mg TDS PO
- Clarithromycin 500 mg BD PO
if severe CAP:
- Co-amox 1.2 mg TDS OR
- cefuroxime and clari
if aspiration:
- Cefuroxim + metronidazole IV
Consider sepsis 6
4
Q
Circulation
A
Look: anaemia, cyanosis
Listen: heart sounds, murmurs
Feel: CRT, pulse, TEMP
HR (high), BP (low)
ECG (sinus tachy??)
IV Access
Bloods:
1. FBC, UEs, LFTs, CRP
2. Blood cultures
Bolus rehydration if hypotensive
5
Q
Disability
A
PEARL
GCS
Neuro exam
BM (adjust if diabetic)
6
Q
Exposure
A
- Expose
- Abdo exam
- Rashes
- Drug chart / allergies to ABx
- Urine dip and urine antigen testing for Pneumococcus and Legionella
- Temperature
7
Q
CANNOT miss for pneumonia
A
- Categorise severity
- Look local guidelines for ABx
- Investigations: XCR, ABG, sputum and blood cultures, urine antigen testing, ECG, CURB 65 score
- Admit in side room
- Escalation: ICU, 2222, med reg if septic, ICU reg if CURB >3
